[Quality of life, depression and cognitive functions 6. Cognitive functions]

The prevalence of cognitive impairment (CI) is reported to be higher in heart failure patients than in the general population.

To describe the prevalence of CI and to assess its prognostic value on the increased risk of hospitalizations and death over the medium term (3 years).

MMSE was administered to 620/745 heart failure patients >70 years. Up to 35% of the tested population were classified as mild CI and 12% as moderate. The severity of baseline clinical conditions, as expressed as NYHA classes, do not appear to be associated to different degrees of CI. The subgroup of patients with moderate CI includes higher proportion of people with the lowest educational level, of feminine gender, of higher age (>80). Even in a population closely monitored as the one included in the GISSI-HLF trial, it is worth to be underlined that the presence of moderate CI appears to be strongly prognostic of an increased burden of care (hospitalizations), and of death over the whole observation period of the study (3 years).

The presence of even mild or moderate CI is prognostic for increased mortality and readmissions for patients of the same NYHA class. In the absence of effective intervention strategies, research should concentrate on the yield, if any, of a systematic screening for CI in heart failure patients.